Topical formulations and uses thereof

ABSTRACT

Provided herein include formulations for topical administration, such as ophthalmic formulations, and methods of using such formulations. In some aspects and embodiments the formulations may include a polyoxyl lipid or fatty acid, and or a polyalkoxylated alcohol and may include nanomicelles. Also include methods of treating or preventing diseases or conditions, such as ocular diseases or conditions.

CLAIM OF PRIORITY

This application is a continuation of U.S. application Ser. No.13/975,175, filed on Aug. 23, 2013, which claims priority to U.S.Provisional Application No. 61/693,189, filed on Aug. 24, 2012, each ofwhich are hereby incorporated by reference in their entirety.

FIELD OF THE INVENTION

The present disclosure relates to the field of formulations for topicaladministration, such as ophthalmic formulations, and methods of usingsuch formulations.

BACKGROUND OF THE INVENTION

The information provided herein and references cited are provided solelyto assist the understanding of the reader, and does not constitute anadmission that any of the references or information is prior art to thepresent invention.

United States Patent Application Nos. US2010/0310462 and US2009/0092665disclose drug delivery systems for ophthalmic use that have nanomicellesthat include vitamin E TPGS.

Travoprost involves a formulation for glaucoma or ocular hypertensionthat includes HCO-40 and a prostaglandin analog as the activeingredient. Seedailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=338e7ff4-0d91-4208-a45d-bfa2be52334don the world-wide web. The active ingredient is present at 0.004%. Theformulation includes propylene glycol and does not include nanomicelles.HCO-40 is present in Travoprost at 0.5%. Seeema.europa.eu/docs/en_GB/document_library/EPAR_-_ProductInformation/human/000665/WC500038389.pdfon the world-wide web.

SUMMARY OF THE INVENTION

The present disclosure relates to topical formulations such asformulations suitable for ophthalmic administration of an activeingredient. In certain aspects and embodiments, the formulations of thepresent disclosure may include a polyoxyl lipid or fatty acid, and or apolyalkoxylated alcohol and may include nanomicelles.

In certain aspects and embodiments as described herein, the formulationsas described herein may have certain surprising features and advantagesthat could not have been predicted prior to the present disclosure. Forexample, formulations of the instant disclosure may be able to support adose of an active ingredient such as a hydrophobic active ingredientthat is surprisingly higher than many prior art formulations. The doseof an active ingredient or agent used in the formulations describedherein may be selected based on various criteria, including the amountthat the formulation can support, the desired dose for varioustherapeutic applications, etc. In this regard, in some embodiments theactive ingredient (such as for ophthalmic administration) the activeagent may be at least about 0.05%, or at least about 0.08%, or at leastabout 0.09%, or at least about 0.1%, or at least about 0.15%; or atleast about 0.2%: or at least about 0.3%: or at least about 0.4%; or atleast about 0.5%; or at least about 0.6%; or at least about 0.7%; or atleast about 0.8%; or at least about 0.9%; or at least about 1.0%; or atleast about 1.5%; or at least about 2%; or at least about 3%; or atleast about 4%; or at least about 5%; or between 0.05 and 5%; or between0.05 and 0.5%; or between 0.05 and 0.2%, or between 0.08 and 0.12%; orbetween 0.1 and 0.5%, or between 0.5 and 1%, or between 0.5 and 1.5%; orbetween 1 and 5%; or between 2 and 4%; or between 4 and 6% of theformulation. In some embodiments the formulation has nanomicelles with arelatively increased entrapment efficiency; in such embodiments theactive agent (such hydrophobic active agents for ophthalmicadministration) may be at least about 0.05%, or at least about 0.08%, orat least about 0.09%, or at least about 0.1%, or at least about 0.15%;or at least about 0.2%: or at least about 0.3%: or at least about 0.4%;or at least about 0.5%; or at least about 0.6%; or at least about 0.7%;or at least about 0.8%; or at least about 0.9%; or at least about 1.0%;or at least about 1.5%; or at least about 2%; or at least about 3%; orat least about 4%; or at least about 5%; or between 0.05 and 5%; orbetween 0.05 and 0.5%; or between 0.05 and 0.2%, or between 0.08 and0.12%; or between 0.1 and 0.5%, or between 0.5 and 1%, or between 0.5and 1.5%; or between 1 and 5%; or between 2 and 4%; or between 4 and 6%of the formulation and is present in nanomicelles of the formulation. Incertain aspects and embodiments, the formulations of the disclosure aresurprisingly effective in dissolving and/or delivering activeingredients (such as hydrophobic active ingredients) without a need fororganic solvents (such as propylene glycol) that can be an irritant whenincluded in ophthalmic formulations. In some embodiments, theformulations of the present disclosure are surprisingly stable at hightemperatures, for example, temperatures above about 40 degrees C. Insome aspects and embodiments the nanomicellular nature of someformulations described herein allow for improved ocular tissuedistribution. In certain aspects and embodiments, formulations asdescribed herein are particularly suitable for anterior eye delivery, orposterior eye delivery, or anterior and posterior eye delivery.Moreover, the formulations of certain aspects and embodiments of thedisclosure may have the surprising advantage of being adaptable tofacilitate delivery of active agents having various sizes or properties;for example, in certain embodiments in formulations that include apolyoxyl castor oil, HCO-60 could be used for active agents havingrelatively small molecule sizes and HCO-80 and/or HCO-100 could be usedfor relatively larger sized active agents.

Accordingly, in a first aspect provided is an ophthalmic formulationthat includes an active agent, a polyoxyl lipid or fatty acid and apolyalkoxylated alcohol. In some embodiments the formulations includesnanomicelles. In some embodiments the polyoxyl lipid or fatty acid is apolyoxyl castor oil. In some embodiments, the polyoxyl lipid or fattyacid is one or more selected from HCO-40, HCO-60, HCO-80 or HCO-100. Insome embodiments the polyoxyl lipid or fatty acid (such as a polyoxylcastor oil such as HCO-40, HCO-60, HCO-80 or HCO-100) is present between1 and 6%; or 2 and 6%; or 2 and 6%; or 3 and 6%; or 4 and 6%; or 2 and5%; or 3 and 5%; or 3 and 5%; or 2 and 6%; or about 4%; or greater than0.7%; or greater than 1%, or greater than 1.5%; or greater than 2%; orgreater than 3%; or greater than 4% by weight of the formulation. Insome embodiments the polyoxyl lipid is HCO-60. In some embodiments thepolyoxyl lipid is HCO-80. In some embodiments the polyoxyl lipid isHCO-100. In some embodiments, the formulation includes a polyalkoxylatedalcohol that is octoxynol-40. In some embodiments, the formulationincludes a polyalkoxylated alcohol (such as octoxynol-40) presentbetween 0.002 and 4%; or between 0.005 and 3%; or 0.005 and 2%; or 0.005and 1%; or 0.005 and 0.5%; or 0.005 and 0.1%; or 0.005 and 0.05%; or0.008 and 0.02%; or about 0.01% by weight of the formulation.

As used herein, the term “polyoxyl lipid or fatty acid” refers to mono-and diesters of lipids or fatty acids and polyoxyethylene diols.Polyoxyl lipids or fatty acids may be numbered (“n”) according to theaverage polymer length of the oxyethylene units (e.g., 40, 60, 80, 100)as is well understood in the art. The term “n 40 polyoxyl lipid” meansthat the ployoxyl lipid or fatty acid has an average oxyethylene polymerlength equal to or greater than 40 units. Stearate hydrogenated castoroil and castor oil are common lipids/fatty acids commercially availableas polyoxyl lipids or fatty acid, however, it is understood that anylipid or fatty acid could polyoxylated to become a polyoxyl lipid orfatty acid as contemplated herein. Examples of polyoxyl lipid or fattyacids include without limitation HCO-40, HCO-60, HCO-80, HCO-100,polyoxyl 40 stearate, polyoxyl 35 castor oil.

In some embodiments of any of the compositions and methods describedherein, the average polymer length of the oxyethylene units of apolyoxyl lipid or fatty acid is longer for a relatively larger activeingredient and is shorter for a relatively smaller active ingredient;for example in some embodiments in which the active ingredient is aresolvin or resolvin-like compound the polyoxyl lipid is HCO-60 and insome embodiments where the active ingredient is cyclosporine A (which islarger than a resolvin) the polyoxyl lipid is HCO-80 or HCO-100.

As used herein, the term “micelle” or “nanomicelle” refers to anaggregate (or cluster) of surfactant molecules. Micelles only form whenthe concentration of surfactant is greater than the critical micelleconcentration (CMC). Surfactants are chemicals that are amphipathic,which means that they contain both hydrophobic and hydrophilic groups.Micelles can exist in different shapes, including spherical,cylindrical, and discoidal. A micelle comprising at least two differentmolecular species is a mixed micelle. The in some embodiments,ophthalmic compositions of the present disclosure include an aqueous,clear, mixed micellar solution

In a second aspect, provided is an ophthalmic formulation, comprising anactive agent, and a n≧40 polyoxyl lipid or fatty acid. In someembodiments the formulations includes nanomicelles. In some embodimentsthe polyoxyl lipid or fatty acid is a polyoxyl castor oil. In someembodiments, the polyoxyl lipid or fatty acid is one or more selectedfrom HCO-40, HCO-60, HCO-80 or HCO-100. In some embodiments the polyoxyllipid or fatty acid (such as a polyoxyl castor oil such as HCO-40,HCO-60, HCO-80 or HCO-100) is present between 0.5 and 2%, or 0.7 and 2%,or 1 and 6%; or 2 and 6%; or 2 and 6%; or 3 and 6%; or 4 and 6%; or 2and 5%; or 3 and 5%; or 3 and 5%; or 2 and 6%; or about 4%; or greaterthan 0.7%; or greater than 1%, or greater than 1.5%; or greater than 2%;or greater than 3%; or greater than 4% by weight of the formulation. Insome embodiments the polyoxyl lipid is HCO-60. In some embodiments thepolyoxyl lipid is HCO-80. In some embodiments the polyoxyl lipid isHCO-100. In some embodiments, the formulation further includespolyalkoxylated alcohol. In some embodiments, the formulation furtherincludes polyalkoxylated alcohol that is octoxynol-40. In someembodiments, the formulation includes a polyalkoxylated alcohol (such asoctoxynol-40) present between 0.002 and 4%; or between 0.005 and 3%; orbetween 0.005 and 2%; or between 0.005 and 1%; or between 0.005 and0.5%; or between 0.005 and 0.1%; or between 0.005 and 0.05%; or between0.008 and 0.02%; or between 0.01 and 0.1%; or between 0.02 and 0.08%; orbetween 0.005 and 0.08%; or about 0.05%, or about 0.01% by weight of theformulation.

In a third aspect, provided is an ophthalmic formulation, that includesan active ingredient (such as a hydrophobic active ingredient) and apolyoxyl lipid or fatty acid; wherein said polyoxyl lipid or fatty acidis present in an amount equal to or greater than 1% of said formulation.In a similar aspect, provided is an ophthalmic formulation, thatincludes an active ingredient (such as a hydrophobic active ingredient)and a polyoxyl lipid or fatty acid; wherein said polyoxyl lipid or fattyacid is present in an amount equal to or greater than 0.05% of saidformulation. In some embodiments the formulations includes nanomicelles.In some embodiments the polyoxyl lipid or fatty acid is a polyoxylcastor oil. In some embodiments, the polyoxyl lipid or fatty acid is oneor more selected from HCO-40, HCO-60, HCO-80 or HCO-100. In someembodiments the polyoxyl lipid or fatty acid (such as a polyoxyl castoroil such as HCO-60, HCO-80 or HCO-100) is present between 0.5 and 2%, or0.7 and 2%, or between 1 and 6%; or 2 and 6%; or 2 and 6%; or 3 and 6%;or 4 and 6%; or 2 and 5%; or 3 and 5%; or 3 and 5%; or 2 and 6%; orabout 4%; or greater than 1.5%; or greater than 2%; or greater than 3%;or greater than 4% by weight of the formulation. In some embodiments thepolyoxyl lipid is HCO-40. In some embodiments the polyoxyl lipid isHCO-60. In some embodiments the polyoxyl lipid is HCO-80. In someembodiments the polyoxyl lipid is HCO-100. In some embodiments, theformulation further includes polyalkoxylated alcohol. In someembodiments, the formulation further includes polyalkoxylated alcoholthat is octoxynol-40. In some embodiments, the formulation includes apolyalkoxylated alcohol (such as octoxynol-40) present between 0.002 and4%; or between 0.005 and 3%; or between 0.005 and 2%; or between 0.005and 1%; or between 0.005 and 0.5%; or between 0.005 and 0.1%; or between0.005 and 0.05%; or between 0.008 and 0.02%; or between 0.01 and 0.1%;or between 0.02 and 0.08%; or between 0.005 and 0.08%; or about 0.05%,or about 0.01% by weight of the formulation.

In a fourth aspect, provided is an ophthalmic formulation, that includesan active agent and a polyoxyl lipid or fatty acid; wherein saidformulation comprises nanomicelles. In some embodiments the polyoxyllipid or fatty acid is a polyoxyl castor oil. In some embodiments, thepolyoxyl lipid or fatty acid is one or more selected from HCO-40,HCO-60, HCO-80 or HCO-100. In some embodiments the polyoxyl lipid orfatty acid (such as a polyoxyl castor oil such as HCO-40, HCO-60, HCO-80or HCO-100) is present between 0.5 and 2%, or 0.7 and 2%, or between 1and 6%; or 2 and 6%; or 2 and 6%; or 3 and 6%; or 4 and 6%; or 2 and 5%;or 3 and 5%; or 3 and 5%; or 2 and 6%; or about 4%; or greater than0.7%; or greater than 1%, or greater than 1.5%; or greater than 2%; orgreater than 3%; or greater than 4% by weight of the formulation. Insome embodiments the polyoxyl lipid is HCO-40. In some embodiments thepolyoxyl lipid is HCO-60. In some embodiments the polyoxyl lipid isHCO-80. In some embodiments the polyoxyl lipid is HCO-100. In someembodiments, the formulation further includes polyalkoxylated alcohol.In some embodiments, the formulation further includes polyalkoxylatedalcohol that is octoxynol-40. In some embodiments, the formulationincludes a polyalkoxylated alcohol (such as octoxynol-40) presentbetween 0.002 and 4%; or between 0.005 and 3%; or between 0.005 and 2%;or between 0.005 and 1%; or between 0.005 and 0.5%; or between 0.005 and0.1%; or between 0.005 and 0.05%; or between 0.008 and 0.02%; or between0.01 and 0.1%; or between 0.02 and 0.08%; or between 0.005 and 0.08%; orabout 0.05%, or about 0.01% by weight of the formulation.

In a further aspect provided is an ophthalmic formulation, comprising anactive agent, 1-5% of one or more selected from the group consisting ofHCO-40, HCO-60, HCO-80 and HCO-100; and about 0.01% octoxynol-40.

In another aspect, provided is ophthalmic formulation, comprising anactive agent, 1-5% of one or more selected from the group consisting ofHCO-40, HCO-60, HCO-80 and HCO-100; and about 0.01% octoxynol-40.

In yet another aspect, provided is an ophthalmic formulation, comprisingan active agent, 1-5% of one or more selected from the group consistingof HCO-40, HCO-60, HCO-80 and HCO-100; and about 0.01% octoxynol-40.

In one aspect, provided is an ophthalmic formulation, comprising anactive agent, 1-5% of one or more selected from the group consisting ofHCO-40, HCO-60, HCO-80 and HCO-100; and about 0.01% octoxynol-40.

In a further aspect provided is an ophthalmic formulation, comprising anactive agent, about 4% of HCO-60 and about 0.01% octoxynol-40.

In another aspect provided is an ophthalmic formulation, comprising anactive agent, 0.7-1.5% of one or more selected from the group consistingof HCO-40, HCO-60, HCO-80 and HCO-100; and about 0.05% octoxynol-40.

In another aspect, provided is ophthalmic formulation, comprising anactive agent, 0.7-1.5% of one or more selected from the group consistingof HCO-40, HCO-60, HCO-80 and HCO-100; and about 0.05% octoxynol-40.

In yet another aspect, provided is an ophthalmic formulation, comprisingan active agent, 0.7-1.5% of one or more selected from the groupconsisting of HCO-40, HCO-60, HCO-80 and HCO-100; and about 0.05%octoxynol-40.

In one aspect, provided is an ophthalmic formulation, comprising anactive agent, 0.7-1.5% of one or more selected from the group consistingof HCO-40, HCO-60, HCO-80 and HCO-100; and about 0.05% octoxynol-40.

In a further aspect provided is an ophthalmic formulation, comprising anactive agent, about 1% of HCO-60 and about 0.05% octoxynol-40.

In various embodiments of any of the aspects and embodiments describedherein, the formulation includes nanomicelles.

In some embodiments of the aspects and embodiments described herein, theformulation includes a polyoxyl lipid or fatty acid. In some embodimentsthe polyoxyl lipid or fatty acid is a polyoxyl castor oil. In someembodiments, the polyoxyl lipid or fatty acid is one or more selectedfrom HCO-40, HCO-60, HCO-80 or HCO-100. In some embodiments the polyoxyllipid or fatty acid (such as a polyoxyl castor oil such as HCO-60,HCO-80 or HCO-100) is present between 0.5 and 2%, or 0.7 and 2%, or 1and 6%; or 2 and 6%; or 2 and 6%; or 3 and 6%; or 4 and 6%; or 2 and 5%;or 3 and 5%; or 3 and 5%; or 2 and 6%; or about 4%; or greater than0.7%; or greater than 1%, or greater than 1.5%; or greater than 2%; orgreater than 3%; or greater than 4% by weight of the formulation. Insome embodiments the polyoxyl lipid is HCO-40. In some embodiments thepolyoxyl lipid is HCO-60. In some embodiments the polyoxyl lipid isHCO-80. In some embodiments the polyoxyl lipid is HCO-100.

In some embodiments of the aspects and embodiments disclosed herein,includes a polyalkoxylated alcohol. In some embodiments, the formulationincludes a polyalkoxylated alcohol that is octoxynol-40. In someembodiments, the formulation includes a polyalkoxylated alcohol (such asoctoxynol-40) present between 0.002 and 4%; or between 0.005 and 3%; orbetween 0.005 and 2%; or between 0.005 and 1%; or between 0.005 and0.5%; or between 0.005 and 0.1%; or between 0.005 and 0.05%; or between0.008 and 0.02%; or between 0.01 and 0.1%; or between 0.02 and 0.08%; orbetween 0.005 and 0.08%; or about 0.05%, or about 0.01% by weight of theformulation.

In some embodiments, the active ingredient is cyclosporine A.

The instant disclosure further relates to treating or preventing oculardiseases or disorders, for example by local administration of theformulations as described herein.

A patient or subject to be treated by any of the compositions or methodsof the present disclosure can mean either a human or a non-human animal.In an embodiment, the present disclosure provides methods for thetreatment of an ocular disease in a human patient in need thereof. In anembodiment, the present disclosure provides methods for the treatment ofan inflammatory ocular disease in a human patient in need thereof. Inanother embodiment, the present disclosure provides methods for thetreatment of an ocular disease in a veterinary patient in need thereof,including, but not limited to dogs, horses, cats, rabbits, gerbils,hamsters, rodents, birds, aquatic mammals, cattle, pigs, camelids, andother zoological animals.

In some embodiments of the compositions and methods disclosed herein,the active agent includes a combination of two or more different activeingredients. In some embodiments the active agent includes two or moreactive agents selected from the group consisting of a resolvin orresolvin-like compound, a steroid (such as a corticosteroid),cyclosporine A, and voclosporin. In some embodiments the active agentincludes a resolvin and cyclosporine A. In some embodiments the activeagent includes cyclosporine A and a corticosteroid. In some embodiments,the active agent includes a resolvin, cyclosporine A and acorticosteroid. In some embodiments, the active agent includes two ormore active agents and one of said active agents is an antibiotic, forexample one or more antibiotics selected from the group consisting ofazythromycin, ciprofloxacin, ofloxacin, gatifloxacin, levofloxacin,moxifloxacin, besifloxacin, and levofloxacin. In some embodiments, theactive agent includes two or more active agents and one of the activeagents is an antibiotic, for example one or more antibiotics selectedfrom the group consisting of azythromycin, ciprofloxacin, ofloxacin,gatifloxacin, levofloxacin, moxifloxacin, besifloxacin, andlevofloxacin; and a second of such agents is a resolvin such asdescribed herein (including without limitation compound 1001). In someembodiments, the active agent includes two or more active agents and oneof said active agents is an antiviral, for example one or moreantivirals selected from the group consisting of ganciclovir,trifluridine, acyclovir, famciclovir, valacyclovir, penciclovir andcidofovir. In some embodiments, the active agent includes two or moreactive agents and one of the active agents is an antibiotic, for exampleone or more antivirals selected from the group consisting ofganciclovir, trifluridine, acyclovir, famciclovir, valacyclovir,penciclovir and cidofovir; and a second of the active agents is aresolvin such as described herein (including without limitation compound1001).

The term “treating” refers to: preventing a disease, disorder orcondition from occurring in a cell, a tissue, a system, animal or humanwhich may be predisposed to the disease, disorder and/or condition buthas not yet been diagnosed as having it; stabilizing a disease, disorderor condition, i.e., arresting its development; and/or relieving one ormore symptoms of the disease, disorder or condition, i.e., causingregression of the disease, disorder and/or condition.

As used herein, a therapeutic that “prevents” a disorder or conditionrefers to a compound that, in a statistical sample, reduces theoccurrence of the disorder or condition in the treated sample relativeto an untreated control sample, or delays the onset or reduces theseverity of one or more symptoms of the disorder or condition relativeto the untreated control sample.

As used herein, the terms “ocular disease,” “ocular condition,” “eyedisease,” and “eye condition” refer to diseases/conditions of the eye(s)that can be sight threatening, lead to eye discomfort, and may signalsystemic health problems.

As used herein, the term “anterior segment disease” refers to alldisorders that affect the eye surface, anterior chamber, iris andciliary body and lens of the eye. The eye surface is composed of thecornea, conjunctiva, eyelids, lacrimal and meibomian glands, and theinterconnecting nerves.

As used herein, the terms “posterior segment eye disease” and“back-of-the-eye disease” refer to all disorders that affect theposterior segment of the eye. A posterior eye disease is a disease whichprimarily affects a posterior ocular site such as choroid or sclera,vitreous, vitreous chamber, retina, optic nerve, and blood vessels andnerves which vascularize or innervate a posterior ocular site.

Accordingly, in one aspect, provided is a method treating or preventingan ocular disease or condition, that includes locally administering aformulation of any of the aspects or embodiments as disclosed herein. Insome embodiments, the ocular disease is an anterior segment disease. Insome embodiments, the ocular disease is a posterior segment disease. Insome embodiments, the ocular disease is one or more selected from thegroup consisting of dry eye syndrome, Sjogren's syndrome, uveitis,anterior uveitis (iritis), chorioretinitis, posterior uveitis,conjunctivitis, allergic conjunctivitis, keratitis,keratoconjunctivitis, vernal keratoconjunctivitis (VKC), atopickeratoconjunctivitis, systemic immune mediated diseases such ascicatrizing conjunctivitis and other autoimmune disorders of the ocularsurface, blepharitis, scleritis, age-related macular degeneration (AMD),diabetic retinopathy (DR), diabetic macular edema (DME), ocularneovascularization, age-related macular degeneration (ARMD),proliferative vitreoretinopathy (PVR), cytomegalovirus (CMV) retinitis,optic neuritis, retrobulbar neuritis, and macular pucker. In oneembodiment, the ocular disease is dry eye. In one embodiment, the oculardisease is allergic conjunctivitis. In one embodiment the ocular diseaseis age-related macular degeneration (AMD). In one embodiment the oculardisease is diabetic retinopathy.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS Active Agents

In accordance various aspects and embodiments of the methods andcompositions provided herein, an active agent can be any agent capableof affecting a biological process. Active agents (the term activeingredient is used herein interchangably with the term active agent)include drugs, hormones, cytokines, toxins, therapeutic agents, vitaminsand the like. In some embodiments an active agent in accordance with theaspects and embodiments disclosed herein is an agent capable of, orapproved for, treating or preventing an disease or condition, forexample in some embodiments an active agent is capable of, or approvedfor, treating or preventing an ocular disease or condition.

In some embodiments, the active agent is an antibiotic, for example oneor more antibiotics selected from the group consisting of azythromycin,ciprofloxacin, ofloxacin, gatifloxacin, levofloxacin, moxifloxacin,besifloxacin, and levofloxacin. In some embodiments, the active agent isan antiviral, for example one or more antivirals selected from the groupconsisting of ganciclovir, trifluridine, acyclovir, famciclovir,valacyclovir, penciclovir and cidofovir.

In some embodiments of any of the aspects and embodiments disclosedherein, the active agent may be a calcineurin inhibitor such ascyclosporine A, voclosporin, ascomycin, tacrolimus, pimecrolimus, ananalog thereof, or a pharmaceutically acceptable salt thereof.

A calcineurin inhibitor of the present disclosure is preferably animmunophilin-binding compound having calcineurin inhibitory activity.Immunophilin-binding calcineurin inhibitors are compounds formingcalcineurin inhibiting complexes with immunophilins, e.g. cyclophilinand macrophilin. Examples of cyclophilin-binding calcineurin inhibitorsare cyclosporines or cyclosporine derivatives (hereinaftercyclosporines) and examples of macrophilin-binding calcineurininhibitors are ascomycin (FR 520) and ascomycin derivatives (hereinafterascomycins). A wide range of ascomycin derivatives are known, which areeither naturally occurring among fungal species or are obtainable bymanipulation of fermentation procedures or by chemical derivatization.Ascomycin-type macrolides include ascomycin, tacrolimus (FK506),sirolimus and pimecrolimus.

Cyclosporine, originally extracted from the soil fungus Potypaciadiuminfilatum, has a cyclic 11-amino acid structure and includes e.g.Cyclosporines A through I, such as Cyclosporine A, B, C, D and G.Cyclosporine binds to the cytosolic protein cyclophilin ofimmunocompetent lymphocytes, especially T-lymphocytes, forming acomplex. The complex inhibits calcineurin, which under normalcircumstances induces the transcription of interleukin-2 (IL-2).Cyclosporine also inhibits lymphokine production and interleukinrelease, leading to a reduced function of effector T-cells.

Ocular Diseases

In various aspects and embodiments the formulations as disclosed hereinmay be used to treat or prevent an ocular disease or disorder. Oculardiseases and disorders contemplated herein include anterior segmentdiseases and posterior segment diseases. Exemplary ocular diseases thatmay in certain embodiments be treated with formulations as disclosedherein include the following.

Dry eye syndrome (DES, Chronic dry eye, Keratitis sicca; Xerophthalmia;Keratoconjunctivitis sicca) can be defined as a condition that includesa variety of disorders that result in a loss of, or altered compositionof, the natural tear film, which maintains the surface of the eye.Without this tear film, vision is impaired and patients may suffersevere ocular discomfort. DES can be caused by excessive tearevaporation or by a reduction of tear production in the lacrimal gland,which is the site of tear production. Though the exact causes of thiscondition are unknown, there is evidence supporting the link betweenreduced tear production and inflammation of one or more components ofthe lacrimal apparatus. Currently available medications for DES areleaving substantial room for more effective and better toleratedproducts.

DES may also be a manifestation of Sjogren's syndrome which is anautoimmune disorder in which the glands that produce tears and salivaare destroyed. This leads to dry mouth, decreased tearing, and other drymucous membranes.

Noninfectious uveitis is a chronic inflammatory, putativeTh1/Th17-mediated autoimmune disease associated with substantial visualmorbidity and is potentially blinding. Blindness from uveitis usuallydoes not occur from a single inflammatory episode; rather, cumulativedamage results from recurrent episodes of inflammation. The inflammatorysequelae resulting in vision loss may include one or more of cystoidmacular edema, cataracts, vitreous debris, glaucoma, macular pathology(scarring and atrophy), optic neuropathy, and retinal detachment.

Anterior uveitis (iritis) occurs in the front of the eye and is the mostcommon form of uveitis. Par planitis is an inflammation of the parsplana, a narrow area between the iris and the choroid. This conditionoccurs more frequently in young men, but is usually not associated withanother disease. Posterior uveitis (chondroitis) affects primarily thechoroid; the back portion of the uveal tract. If the retina is alsoinvolved, it is called chorioretinitis. Posterior uveitis may occur inassociation with an autoimmune disease, or follow a systemic infection.In posterior uveitis, inflammation can last from months to years and maycause permanent vision damage, even with treatment.

Uveitis can cause vision impairment, ocular pain, and loss of vision. Itis estimated that about 10% of new cases of blindness in the U.S. arecaused by uveitis. Approximately 300,000 people suffer from uveitis inthe U.S. alone, the majority of whom are affected by anterior uveitis.The only therapeutic class approved by the FDA for treatment of uveitisis corticosteroids, which are noted for multiple side effects, such ashypertension, hyperglycemia, and hypercholesterolemia, and in the eye,glaucoma and cataract formation.

Conjunctivitis (pink eye) describes a group of diseases that causeswelling, itching, burning, and redness of the conjunctiva, theprotective membrane that lines the eyelids and covers exposed areas ofthe sclera, or white of the eye.

Keratitis is an inflammation of the cornea (clear portion in the frontof the eye). Keratitis can be caused by an infection (bacterial, fungal,viral, parasite, etc.) or a non-infectious agent (e.g., certain types ofauto-immune diseases are associated with a variety of non-infectiouskeratitises).

Keratoconjunctivitis refers to an inflammation of the cornea andconjunctiva.

Vernal keratoconjunctivitis (VKC) is a recurrent ocular inflammatorydisease characterized by hard, elevated, cobblestone like bumps on theupper eyelid. There may also be swellings and thickening of theconjunctiva. The conjunctiva is the outermost membrane which lines theeyelids as well as the exposed parts of the eye, except for the cornea.

Atopic keratoconjunctivitis is the result of a condition called atopy.Atopy is a genetic condition whereby the immune system produces higherthan normal antibodies in response to a given allergen.

Systemic immune mediated diseases such as cicatrizing conjunctivitis andother autoimmune disorders of the ocular surface represent a clinicallyheterogeneous group of conditions where acute and chronic autoreactivemechanisms can cause significant damage to the eye. When severe andaffecting the epithelium and substantia propria of the conjunctiva,cicatrization can ensue, leading to significant mechanical alterationsas a result of the fibrosis. These conditions, though generallyinfrequent, can be the cause of profound pathology and visualdisability.

Blepharitis is a common condition that causes inflammation of theeyelids.

Scleritis is a serious inflammatory disease that affects the white outercoating of the eye, known as the sclera.

Age-related macular degeneration (AMD) is a disease associated withaging that gradually destroys sharp, central vision. AMD affects themacula, which is located at the center of the retina. AMD occurs in twoforms: wet and dry. Wet AMD occurs when abnormal blood vessels behindthe retina start to grow under the macula. These new blood vessels tendto be very fragile and often leak blood and fluid. The blood and fluidraise the macula from its normal place at the back of the eye. Damage tothe macula occurs rapidly. Dry AMD occurs when the light-sensitive cellsin the macula slowly break down, gradually blurring central vision inthe affected eye.

Diabetes can affect the eye in a number of ways. Diabetic retinopathy(DR) is a complication of diabetes that results from damage to the bloodvessels of the light-sensitive tissue at the back of the eye (theretina). At first, diabetic retinopathy may cause no symptoms or onlymild vision problems. Eventually, however, diabetic retinopathy canresult in blindness. Diabetic macular edema (DME) is the swelling of theretina in diabetes mellitus due to leaking of fluid from blood vesselswithin the macula.

Ocular neovascularization is the abnormal or excessive formation ofblood vessels in the eye. Ocular neovascularization has been shown indiabetic retinopathy and age-related macular degeneration (AMD).

Proliferative vitreoretinopathy (PVR) is scar tissue formation withinthe eye. “Proliferative” because cells proliferate and“vitreoretinopathy” because the problems involve the vitreous andretina. In PVR scar tissue forms in sheets on the retina which contract.This marked contraction pulls the retina toward the center of the eyeand detaches and distorts the retina severely. PVR can occur bothposteriorly and anteriorly with folding of the retina both anteriorlyand circumferentially.

The cytomegalovirus (CMV) is related to the herpes virus and is presentin almost everyone. When a person's immune system is suppressed becauseof disease (HIV), organ or bone marrow transplant, or chemotherapy, theCMV virus can cause damage and disease to the eye and the rest of thebody. CMV affects the eye in about 30% of the cases by causing damage tothe retina. This is called CMV retinitis.

Optic neuritis occurs when the optic nerve becomes inflamed and themyelin sheath becomes damaged or is destroyed. Nerve damage that occursin the section of the optic nerve located behind the eye, is calledretrobulbar neuritis, which is another term sometimes used for opticneuritis.

Also known as macular pucker, epiretinal membrane is a scar-tissue likemembrane that forms over the macula. It typically progresses slowly andaffects central vision by causing blurring and distortion. As itprogresses, the pulling of the membrane on the macula may causeswelling.

In an embodiment, the compositions can be used for preventing transplantrejection of, for example, corneal allografts following transplantation.It is well known that in inflammation T-lymphocytes play a critical rolein mediating rejection of foreign tissues. Prevention of rejection is ofparamount importance in maintaining the health of transplanted corneas.Rejection may occur in any of the layers comprising the cornea, forexample, the corneal epithelium, the corneal stroma or the cornealendothelium. The functioning of the cornea can be compromised followingendothelial rejection. The endothelial layer serves to maintain thecornea in a compact state, acting as a pump by removing water from thecorneal stroma. If the function of the endothelial layer is compromised,disorientation of collagen fibers can ensue, and transparency of thecornea can be lost. Human endothelial cells are non-replicative, and asa consequence, donor cell loss in the setting of rejection isirreversible and may lead to diminished graft function and survival.Thus, the goal of either prevention or treatment of rejection in cornealtransplant recipients is to minimize endothelial cell loss. Thecompositions of the present disclosure can be used for the prevention ofrejection following corneal allograft transplantation.

Additional Formulation Ingredients

The compositions of the present disclosure may also contain othercomponents such as, but not limited to, additives, adjuvants, buffers,tonicity agents, bioadhesive polymers, and preservatives. In any of thecompositions of this disclosure for topical to the eye, the mixtures arepreferably formulated at about pH 5 to about pH 8. This pH range may beachieved by the addition of buffers to the composition as described inthe examples. In an embodiment, the pH range in the composition in aformulation is about pH 6.6 to about pH 7.0. It should be appreciatedthat the compositions of the present disclosure may be buffered by anycommon buffer system such as phosphate, borate, acetate, citrate,carbonate and borate-polyol complexes, with the pH and osmolalityadjusted in accordance with well-known techniques to properphysiological values. The mixed micellar compositions of the presentdisclosure are stable in buffered aqueous solution. That is, there is noadverse interaction between the buffer and any other component thatwould cause the compositions to be unstable.

Tonicity agents include, for example, mannitol, sodium chloride,xylitol, etc. These tonicity agents may be used to adjust the osmolalityof the compositions. In one aspect, the osmolality of the formulation isadjusted to be in the range of about 250 to about 350 mOsmol/kg. In apreferred aspect, the osmolality of the formulation is adjusted tobetween about 280 to about 300 mOsmol/kg.

An additive such as a sugar, a glycerol, and other sugar alcohols, canbe included in the compositions of the present disclosure.Pharmaceutical additives can be added to increase the efficacy orpotency of other ingredients in the composition. For example, apharmaceutical additive can be added to a composition of the presentdisclosure to improve the stability of the calcineurin inhibitor or mTORinhibitor, to adjust the osmolality of the composition, to adjust theviscosity of the composition, or for another reason, such as effectingdrug delivery. Non-limiting examples of pharmaceutical additives of thepresent disclosure include sugars, such as, trehalose, mannose,D-galactose, and lactose. In an embodiment, the sugars can beincorporated into a composition prior to hydrating the thin film (i.e.,internally). In another embodiment, the sugars can be incorporated intoa composition during the hydration step (i.e., externally) (see Example17). In an embodiment, an aqueous, clear, mixed micellar solution of thepresent disclosure includes additives such as sugars.

In an embodiment, compositions of the present disclosure furthercomprise one or more bioadhesive polymers. Bioadhesion refers to theability of certain synthetic and biological macromolecules andhydrocolloids to adhere to biological tissues. Bioadhesion is a complexphenomenon, depending in part upon the properties of polymers,biological tissue, and the surrounding environment. Several factors havebeen found to contribute to a polymer's bioadhesive capacity: thepresence of functional groups able to form hydrogen bridges (—OH, COOH),the presence and strength of anionic charges, sufficient elasticity forthe polymeric chains to interpenetrate the mucous layer, and highmolecular weight. Bioadhesion systems have been used in dentistry,orthopedics, ophthalmology, and in surgical applications. However, therehas recently emerged significant interest in the use of bioadhesivematerials in other areas such as soft tissue-based artificialreplacements, and controlled release systems for local release ofbioactive agents. Such applications include systems for release of drugsin the buccal or nasal cavity, and for intestinal or rectaladministration.

In an embodiment, a composition of the present disclosure includes atleast one bioadhesive polymer. The bioadhesive polymer can enhance theviscosity of the composition and thereby increase residence time in theeye. Bioadhesive polymers of the present disclosure include, forexample, carboxylic polymers like Carbopol® (carbomers), Noveon®(polycarbophils), cellulose derivatives including alkyl and hydroxyalkylcellulose like methylcellulose, hydroxypropylcellulose,carboxymethylcellulose, gums like locust beam, xanthan, agarose, karaya,guar, and other polymers including but not limited to polyvinyl alcohol,polyvinyl pyrollidone, polyethylene glycol, Pluronic® (Poloxamers),tragacanth, and hyaluronic acid; phase-transition polymers for providingsustained and controlled delivery of enclosed medicaments to the eye(e.g., alginic acid, carrageenans (e.g., Eucheuma), xanthan and locustbean gum mixtures, pectins, cellulose acetate phthalate,alkylhydroxyalkyl cellulose and derivatives thereof, hydroxyalkylatedpolyacrylic acids and derivatives thereof, poloxamers and theirderivatives, etc. Physical characteristics in these polymers can bemediated by changes in environmental factors such as ionic strength, pH,or temperature alone or in combination with other factors. In anembodiment, the optional one or more bioadhesive polymers is present inthe composition from about 0.01 wt % to about 10 wt %/volume, preferablyfrom about 0.1 to about 5 wt %/volume. In an embodiment, thecompositions of the present disclosure further comprise at least onehydrophilic polymer excipient selected from, for example, PVP-K-30,PVP-K-90, HPMC, HEC, and polycarbophil. In an embodiment, the polymerexcipient is selected from PVP-K-90, PVP-K-30 or HPMC. In an embodiment,the polymer excipient is selected from PVP-K-90 or PVP-K-30.

In an embodiment, if a preservative is desired, the compositions mayoptionally be preserved with any of many well-known preservatives,including benzyl alcohol with/without EDTA, benzalkonium chloride,chlorhexidine, Cosmocil® CQ, or Dowicil® 200. In certain embodiments, itmay be desireable for a formulation as described herein to not includeany preservatives. In this regard, preservatives may in some embodimentsnot be necessary or desirable in formulations included in single usecontainers. In other embodiments it may be advantageous to includepreservatives, such as in certain embodiments in which the formulationsare included in a multiuse container.

The ophthalmic compositions can be administered topically to the eye asbiocompatible, aqueous, clear mixed micellar solutions. The compositionshave the drugs incorporated and/or encapsulated in micelles which aredispersed in an aqueous medium.

Non-Limiting List of Exemplary Embodiments

In addition to the aspects and embodiments described and providedelsewhere in this disclosure, the following non-limiting list ofparticular embodiments are specifically contemplated.

1. An ophthalmic formulation, comprising an active agent, a polyoxyllipid or fatty acid and a polyalkoxylated alcohol.

2. An ophthalmic formulation, comprising an active agent, and a n 40polyoxyl lipid or fatty acid.

3. An ophthalmic formulation, comprising an active ingredient and apolyoxyl lipid or fatty acid; wherein said polyoxyl lipid or fatty acidis present in an amount equal to or greater than 1% of said formulation.

4. An ophthalmic formulation, comprising an active agent and a polyoxyllipid or fatty acid; wherein said formulation comprises nanomicelles.

5. An ophthalmic formulation, comprising an active agent, 1-5% of one ormore selected from the group consisting of HCO-40, HCO-60, HCO-80 andHCO-100; and about 0.01-0.1% octoxynol-40.

6. An ophthalmic formulation, comprising an active agent, 1-5% of one ormore selected from the group consisting of HCO-40, HCO-60, HCO-80 andHCO-100; and about 0.01-0.1% octoxynol-40.

7. An ophthalmic formulation, comprising greater than 0.2% of an activeagent, 1-5% of one or more selected from the group consisting of HCO-40,HCO-60, HCO-80 and HCO-100; and about 0.01-0.1% octoxynol-40.

8. An ophthalmic formulation, comprising an active agent, 1.5-4% of oneor more polyoxl lipids selected from the group consisting of HCO-40,HCO-60, HCO-80 and HCO-100; and about 0.01-0.1% octoxynol-40.

9. An ophthalmic formulation, comprising an active agent, 1.5-4% ofpolyoxl lipids or fatty acids; and about 0.01-0.1% octoxynol-40.

10. An ophthalmic formulation, comprising an active agent, 1.5-4% ofpolyoxl lipids or fatty acids; and about 0.01-0.1% octoxynol-40; whereinthe formulation comprises nanomicelles.

11. An ophthalmic formulation, comprising a hydrophobic active agent,1.5-4% of polyoxl lipids or fatty acids; and about 0.01-0.1%octoxynol-40; wherein the formulation comprises nanomicelles.

12. An ophthalmic formulation, comprising an active agent, about 4% ofone or more selected from the group consisting of HCO-40, HCO-60, HCO-80and HCO-100; and about 0.01-0.1% octoxynol-40.

13. An ophthalmic formulation, comprising an active agent, about 4% ofHCO-60 and about 0.01-0.1% octoxynol-40.

14. An ophthalmic formulation, comprising an active agent, 1-5% of oneor more selected from the group consisting of HCO-40, HCO-60, HCO-80 andHCO-100; and about 0.01% octoxynol-40.

15. An ophthalmic formulation, comprising an active agent, 1-5% of oneor more selected from the group consisting of HCO-40, HCO-60, HCO-80 andHCO-100; and about 0.01% octoxynol-40.

16. An ophthalmic formulation, comprising greater than 0.2% of an activeagent, 1-5% of one or more selected from the group consisting of HCO-40,HCO-60, HCO-80 and HCO-100; and about 0.01% octoxynol-40.

17. An ophthalmic formulation, comprising an active agent, 1.5-4% of oneor more polyoxl lipids selected from the group consisting of HCO-40,HCO-60, HCO-80 and HCO-100; and about 0.01% octoxynol-40.

18. An ophthalmic formulation, comprising an active agent, 1.5-4% ofpolyoxl lipids or fatty acids; and about 0.01% octoxynol-40.

19. An ophthalmic formulation, comprising an active agent, 1.5-4% ofpolyoxl lipids or fatty acids; and about 0.01% octoxynol-40; wherein theformulation comprises nanomicelles.

20. An ophthalmic formulation, comprising a hydrophobic active agent,1.5-4% of polyoxl lipids or fatty acids; and about 0.01% octoxynol-40;wherein the formulation comprises nanomicelles.

21. An ophthalmic formulation, comprising an active agent, about 4% ofone or more selected from the group consisting of HCO-40, HCO-60, HCO-80and HCO-100; and about 0.01% octoxynol-40.

22. An ophthalmic formulation, comprising an active agent, about 4% ofHCO-60 and about 0.01% octoxynol-40.

23. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 0.5 and 6% by weight of saidformulation.

24. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 0.5 and 2% by weight of saidformulation.

25. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 0.5 and 3% by weight of saidformulation.

26. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 0.5 and 4% by weight of saidformulation.

27. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 0.5 and 5% by weight of saidformulation.

28. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 1 and 6% by weight of saidformulation.

29. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 1 and 2% by weight of saidformulation.

30. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 1 and 3% by weight of saidformulation.

31. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 1 and 4% by weight of saidformulation.

32. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 1 and 5% by weight of saidformulation.

33. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 1 and 6% by weight of saidformulation.

34. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 2 and 6% by weight of saidformulation.

35. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 3 and 6% by weight of saidformulation.

36. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 4 and 6% by weight of saidformulation.

37. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 2 and 5% by weight of saidformulation.

38. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is between 3 and 5% by weight of saidformulation.

39. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is about 4% by weight of said formulation.

40. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is greater than about 0.7% by weight ofsaid formulation.

41. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is greater than about 1% by weight of saidformulation.

42. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is greater than about 1.5% by weight ofsaid formulation.

43. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is greater than about 2% by weight of saidformulation.

44. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is greater than about 3% by weight of saidformulation.

45. The formulation of any of the preceding embodiments, wherein saidpolyalkoxylated alcohol if present is between 0.002 and 4% by weight ofsaid formulation.

46. The formulation of any of the preceding embodiments, wherein saidpolyalkoxylated alcohol if present is between 0.005 and 3% by weight ofsaid formulation.

47. The formulation of any of the preceding embodiments, wherein saidpolyalkoxylated alcohol if present is between 0.005 and 2% by weight ofsaid formulation.

48. The formulation of any of the preceding embodiments, wherein saidpolyalkoxylated alcohol if present is between 0.005 and 1% by weight ofsaid formulation.

49. The formulation of any of the preceding embodiments, wherein saidpolyalkoxylated alcohol if present is between 0.005 and 0.5% by weightof said formulation.

50. The formulation of any of the preceding embodiments, wherein saidpolyalkoxylated alcohol if present is between 0.005 and 0.1% by weightof said formulation.

51. The formulation of any of the preceding embodiments, wherein saidpolyalkoxylated alcohol if present is between 0.005 and 0.05% by weightof said formulation.

52. The formulation of any of the preceding embodiments, wherein saidpolyalkoxylated alcohol if present is between 0.008 and 0.02% by weightof said formulation.

53. The formulation of any of the preceding embodiments, wherein saidpolyalkoxylated alcohol if present is about 0.01% by weight of saidformulation.

54. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 0.2%.

55. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 0.3%.

56. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 0.4%.

57. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 0.5%.

58. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 0.6%.

59. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 0.7%.

60. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 0.8%.

61. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 0.9%.

62. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 1%.

63. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 1.5%.

64. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 2%.

65. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 3%.

66. The formulation of any of the preceding embodiments, wherein saidactive ingredient is present in said formulation in an amount greaterthan 4%.

67. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is a polyoxyl castor oil.

68. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is one or more selected from HCO-60, HCO-80or HCO-100.

69. The formulation of any of the preceding embodiments, wherein saidpolyoxyl lipid or fatty acid is HCO-60.

70. The formulation of any of the preceding embodiments, wherein saidactive agent is one or more selected from the group consisting ofcyclosporine A, voclosporin, ascomycin, tacrolimus, pimecrolimus, ananalog thereof, or a pharmaceutically acceptable salt thereof.

71. The formulation of any of the preceding embodiments, wherein saidactive agent is cyclosporine A.

72. The formulation of any of the preceding embodiments, wherein saidactive agent is voclosporin.

73. The formulation of any of the preceding embodiments, wherein saidactive agent comprises a combination of two different agents.

74. The formulation of any of the preceding embodiments, wherein theactive agent comprises two or more active agents selected from the groupconsisting of a resolvin or resolvin-like compound, a steroid (such as acorticosteroid), cyclosporine A, and voclosporin.

75. The formulation of any of the preceding embodiments, wherein theactive agent comprises a resolvin and a corticosteroid.

76. The formulation of any of the preceding embodiments, wherein theactive agent comprises cyclosporine A and a corticosteroid.

77. The formulation of any of the preceding embodiments, wherein theactive agent comprises a resolvin, cyclosporine A and a corticosteroid.

78. The formulation of any of the preceding embodiments, wherein saidformulation does not include preservatives.

79. The formulation of any of the preceding embodiments, wherein saidformulation does not include benzyl alcohol with/without EDTA,benzalkonium chloride, chlorhexidine, Cosmocil® CQ, or Dowicil® 200.

80. A method of treating or preventing an ocular disease or condition,said method comprising topically administering a formulation of any ofthe preceding embodiments.

81. A method of treating or preventing an ocular disease or condition,said method comprising topically administering a formulation of any ofthe preceding embodiments; wherein said disease is an anterior segmentdisease.

82. A method of treating or preventing an ocular disease or condition,said method comprising topically administering a formulation of any ofthe preceding embodiments; wherein said disease is an posterior segmentdisease.

83. A method of treating or preventing an ocular disease or condition,said method comprising topically administering a formulation of any ofthe preceding embodiments; wherein said disease is one or more selectedfrom the group consisting of dry eye syndrome, Sjogren's syndrome,uveitis, anterior uveitis (iritis), chorioretinitis, posterior uveitis,conjunctivitis, allergic conjunctivitis, keratitis,keratoconjunctivitis, vernal keratoconjunctivitis (VKC), atopickeratoconjunctivitis, systemic immune mediated diseases such ascicatrizing conjunctivitis and other autoimmune disorders of the ocularsurface, blepharitis, scleritis, age-related macular degeneration (AMD),diabetic retinopathy (DR), diabetic macular edema (DME), ocularneovascularization, age-related macular degeneration (ARMD),proliferative vitreoretinopathy (PVR), cytomegalovirus (CMV) retinitis,optic neuritis, retrobulbar neuritis, and macular pucker.

84. A method of treating or preventing an ocular disease or condition,said method comprising topically administering a formulation of any ofthe preceding embodiments; wherein said disease is dry eye syndrome.

85. A method of treating or preventing an ocular disease or condition,said method comprising topically administering a formulation of any ofthe preceding embodiments; wherein said disease is allergicconjunctivitis.

86. A method of treating or preventing an ocular disease or condition,said method comprising topically administering a formulation of any ofthe preceding embodiments; wherein said disease is age-related maculardegeneration (AMD).

The following examples are provided to further illustrate aspects of theinvention. These examples are non-limiting and should not be construedas limiting any aspect of the invention.

Example 1 Preparation of Mixed Nanomicellar Resolvin Formulation UsingDialysis Method

Mixed nanomicellar formulation of compound 1001 was prepared by dialysismethod with varying ratio of polymers and the drug. Experimental designsoftware, JMP 9.0 was used to design the experiments and analyze theresults. Accurately weighted quantities of two polymers namely polyoxylhydrogenated castor-60 (HCO-60) and octoxynol-40 (Oc-40) were dissolvedin 300 microliter volume of propylene glycol. Eighty microliter (or 80mg of compound 1001 in PG) of propylene glycol containing compound 1001was added to this polymer mixture and vortex mixed to get a clearhomogenous solution. The volume of the mixture was made up (500microliters) with propylene glycol. The solution was vortex mixed to geta homogenous solution. A volume of 500 microliter distilled deionizedwater was added to this mixture to obtain a total volume of 1000microliter (1 milliliter). Addition of water to the drug polymer mixturein organic solvent should spontaneously generate micelles therebyentrapping the pharmaceutical active agent in the hydrophobic core ofmixed nanomicelles. The mixture was transferred to a dialysis bag(molecular weight cut off 1000) and transferred to a beaker containingone liter of distilled deionized water. Beaker and the contents wereprotected from sunlight by covering with aluminum foil and were keptunder slow constant stirring at room temperature. Dialysis of themixture was carried over a period of 24 h to remove the water solubleorganic solvent, propylene glycol, from the mixture. Water in thedialysis chamber was changed at predetermined time points: 1 h, 2 h, 4h, 6 h, 12 h and 24 h. At the end of dialysis (24 h), the contents ofthe dialysis bag were carefully transferred to a 15-mL centrifuge tubeand formulations were subjected to sonication in water bath (time rangefrom 0 min to 5 min). The final volume was made up with 2× phosphatebuffer saline and adjusted pH of the formulation to 6.5±0.1. Theresultant formulation was filtered with 0.22 micrometer nylon filter toremove any foreign particulate matter.

The prepared formulations were subjected to various tests such asentrapment efficiency, loading efficiency, mixed nanomicellar size andpolydispersity index.

Mixed Nanomicellar Size and Polydispersity Index:

The formulation size and polydispersity index were determined withZetasizer, Malvern Instruments, NJ. In brief, approximately 1 ml of eachformulation was transferred to a cuvette and placed in the instrument. Alaser beam of light was used to determine the mixed nanomicellar size.The results of the size are summarized in Table 2.

Entrapment Efficiency:

To determine the entrapment efficiency of the formulation, all theprepared formulations were subjected to entrapment efficiency test.Briefly, formulations were vortex mixed for homogeneity and 1 mL wastransferred to a fresh (1.5 mL) eppendorf tube. Each formulation waslyophilized to obtain a solid at the bottom of eppendorf tube. Theobtained solid was suspended in 1 mL of organic solvent (diethyl ether)to generate reverse micelles and release the drug into the externalorganic solvent. The organic solvent was evaporated overnight in speedvacuum. The resultant reversed micelles were resuspended in 1 mL of2-propanol (dilution factor was taken into account) and further dilutedto determine the concentration of compound 1001 entrapped in eachmicellar preparation with HPLC. The entrapment efficiency of theformulation was calculated with the following formula (wherein MNF=MixedNanomicellar Formulation):

${{Entrapment}\mspace{14mu} {efficiency}} = {\frac{\left( {{amount}\mspace{14mu} {of}\mspace{14mu} {drug}\mspace{14mu} {quantified}\mspace{14mu} {in}\mspace{14mu} {MNF}} \right)}{{Amount}\mspace{14mu} {of}\mspace{14mu} {drug}\mspace{14mu} {added}\mspace{14mu} {in}\mspace{14mu} {the}\mspace{14mu} {MNF}} \times 100}$

Drug Quantification by an HPLC Method:

In vitro analysis of compound 1001 was performed by a reversed phasehigh performance liquid chromatography (RP-HPLC) method with a ShimadzuHPLC pump (Shimadzu, Shimadzu Scientific instruments, Columbia, Md.),Alcott autosampler (model 718 AL), Shimadzu UV/Visible detector(Shimadzu, SPD-20A/20AV, USA), ODS column (5 μm, 150×4.6 mm)thermostated at 40°±1C. and Hewlett Packard HPLC integrator (HewlettPackard, Palo Alto, Calif.). The mobile phase was comprised of methanol(MeOH), water and trifluoroacetic acid (TFA) (70:30:0.05% v/v) which wasset at a flow rate of 0.5 mL/min. Detection wavelength was set at 272nm. The sample tray temperature was maintained at 4° C. Calibrationcurve (0.5 to 5 μg/mL) for compound 1001 was prepared by makingappropriate dilutions from the stock solution in 2-propanol. Aninjection volume of 10 μl was injected into the HPLC column foranalysis. All the standards and samples prepared were stored at 4° C.before and during the analysis.

Example 2 Preparation of Mixed Nanomicellar Resolvin Formulation UsingEthyl Acetate Solvent Evaporation Method

Mixed nanomicellar formulation encapsulating compound 1001 was preparedby solvent evaporation method in two steps: 1) Preparation of basicformulation and 2) rehydration. In step one, compound 1001, HCO-60 andoctoxynol-40 were dissolved separately in 0.3 mL of ethyl acetate. Thesethree solutions were mixed together in 15-mL centrifuge tube. Theresultant mixture was vortexed to obtain a homogenous solution. Ethylacetate solvent was removed with speed vacuum to obtain a solid thinfilm. The residue was kept overnight under high vacuum at roomtemperature to remove residual organic solvent. In step two, theresultant thin film was hydrated with 1 mL of double distilled deionizedwater by vortexing the solution. The rehydrated formulation wassuspended in 2× phosphate buffer solution, (pH 6.5). It was filteredthrough 0.2 μm nylon filter membrane to remove the unentrapped drugaggregates and other foreign particulates. The entrapment of compound1001 was determined by RP-HPLC following disruption of the micelles andsolubilization of 1001 in the diluent (2-propanol) as described below

The prepared formulations were subjected to various tests such asentrapment efficiency, loading efficiency, mixed nanomicellar size andpolydispersity index according to the methods described in Example 1.

Weight percent of drug loaded into MNF was determined following themethod for entrapment efficiency. Size and polydispersity index of theformulations was determined with Malvern zetasizer as described above.The results obtained are summarized in Table 1 below. The formulationsappear clear and have small size and narrow size distribution.

TABLE 1 Characterization of the mixed nanomicellar formulationencapsulating compound 1001 with solvent evaporation method 1001 1001(loaded (initially in mixed Mixed HCO-60 Octoxynol-40 added) micelles)nanomicellar Polydispersity (wt %) (wt %) wt % wt % size (nm) IndexResult 4 0.01 0.035 0.033 24.90 0.442 Clear/transparent solution beforeand after filtration 4 0.01 0.070 0.065 25.01 0.414 Clear/transparentsolution before and after filtration 4 0.01 0.095 0.084 24.79 0.415Clear/transparent solution before and after filtration 4 0.01 0.120 0.1118.28 0.320 Pale yellow color transparent solution before and afterfiltration 4 0.01 0.250 0.26 18.37 0.331 Yellow color solution beforeand after filtration 4 0.01 0.300 0.32 18.29 0.345 Yellow color 4 0.010.400 0.45 18.2 0.333 solution before and after filtration

Example 3 Preparation of Mixed Nanomicellar Resolvin Formulation UsingMelt Method

Two hundred milligrams of hydrogenated castor oil-60 (HCO-60) (4 wt %)was weighed and transferred to a 10 mL round bottom flask (RBF). Theneck of the round bottom flask was closed with an aluminum foil, sealedwith parafilm and transferred to water bath set at 40 C. The roundbottom flask was left overnight in water bath to liquefy/melt theHCO-60. On the next day, ten micro liters of octoxynol-40 was diluted100 folds and allowed to equilibrate at 40 C for 1 h in water bath.Similarly, compound 1001 (neat oil) was allowed to equilibrate at 40 Cin the water bath for 1 h. To the HCO-60 melt, 50 μL of 100 fold dilutedoctoxynol-40 (0.01 wt %) was added at 40 C. To the above mixture, ˜20 μLof compound 1001 at 40 C was added and was stirred. To this mixturedistilled deionized water, approx. 2 mL, equilibrated at 40 C was slowlyadded and stirred. The neck of the round bottom flask was closed withaluminum foil and sealed with parafilm. The solution was stirred inwater bath set at 40 C overnight protected from light (covering withaluminum foil). On the next day, the above obtained solution at 40 C wasremoved from water bath and allowed to cool to room temperature andobserved for clarity. Two milliliters phosphate buffer (2×) was added tothe above prepared solution (phosphate buffer was previously preparedand the pH was adjusted to 5.5). The volume of the formulation was madeup to 5 mL with the 2× phosphate buffer saline. The prepared formulationwas filtered with 0.2 μm nylon filter and stored at 4 C.

The prepared formulations were subjected to various tests such asentrapment efficiency, loading efficiency, mixed nanomicellar size andpolydispersity index according to the methods described in Example 1.

Example 4 Preparation of Mixed Nanomicellar Resolvin Formulation UsingSecond Melt Method

The preparation of MNF encapsulating compound 1001 (neat oil) can bedivided into two steps. As an example for the development of 3.0 wt %HCO-40 or HCO-60 MNF encapsulating 0.4% compound 1001 is describedbelow. In step 1, HCO-40 or HCO-60, 150 mg, was thermostated at 40° C.in water bath to melt and result in a clear thick viscous liquid. Tothis melt polymer compound 1001 (˜20 mg), thermostated at 40° C., wasadded and mixed for homogenous distribution. The mixture was allowed toreach room temperature, which resulted in a pale yellow color viscousliquid with HCO-40 and waxy solid with HCO-60. Further, to solidify theviscous liquid of HCO-40, the mixture was stored at 4° C. (inrefrigerator).

In step 2, the pellet and/or viscous liquid was allowed to reach roomtemperatures under natural conditions. The pellet and/or viscous liquidwas thermostated in water bath at 40° C. and resuspended in 2.0 mL ofdistilled water (thermostated at 40° C.) under constant stirring. Thisresulted in spontaneous development of a clear aqueous solution of 0.4%compound 1001 MNF. This aqueous solution was allowed to reach roomtemperature, under natural conditions. The pH of the solution wasadjusted to 5.5 and the volume was made up with 2× phosphate buffersaline (pH 5.5) containing octoxynol-40 (0.01 wt %) and PVP-K-90 (1.2 wt%). The formulation was filtered through 0.2 μm nylon filter to removeany foreign material and obtain a clear homogenous aqueous RX-1001formulation.

¹H NMR qualitative studies: To determine the absence of free drug in theouter aqueous environment, qualitative studies were conducted.Qualitative proton nuclear magnetic resonance (NMR) studies wereconducted with Varian 400 MHz NMR. Deuterated chloroform and water assolvent systems were used to resuspend the formulation and NMR studieswere performed.

Results:

Compound added to HCO-40 or HCO-60 at 40° C. can be used to entrap thecompound 1001. At higher temperatures the polymer and the drug mixtureremains in viscous liquid state. When allowed to reach room temperature,under natural conditions, HCO-60 mixture solidifies and develops a waxysolid. This waxy solid when thermostated at 40° C., helps inresuspending the formulation in distilled water to spontaneously developcompound 1001 MNF. Similar observation and results were obtained withHCO-40 viscous liquid. The viscosity of the mixture appears to beimproved at lower temperatures (4° C.). Therefore, it appears to stickto the walls of the container as thick viscous liquid. Upon allowing toreach back to room temperature the viscosity appears to be reduced andthe mixture retains its flow back.

The waxy solid developed with HCO-60 and compound 1001 mixture may behelpful to protect the drug and prevent the drug degradation with asurface blanket of an inert gas. The other polymer (HCO-40) did notresult in development of waxy solid at room temperature or at lowrefrigerated conditions (4° C.) when used up to approx. 3.0 wt %.

Qualitative proton NMR studies show that resuspending the formulation inthe aqueous phase (D₂O) spontaneously generated mixed nanomicelles andno free drug peaks were evident in the aqueous solution. If the drug wasnot entrapped in the core of mixed nanomicelles then the oil would befloating at the surface as a separate oil phase. While on the otherhand,resuspending the same formulation in organic solvent such as deuteratedchloroform (CDCl₃) showed distinct peaks corresponding to drug alongwith polymer peaks. This indicates that the drug was not encapsulated inthe micelle core and freely available when present in organic solvent.

The results obtained for physical appearance of the mixture, differentphases, at different temperatures and appearance of final formulationare summarized in Tables 2a-2c.

TABLE 2a Physical appearance of melt mixture of HCO-60 and Compound 1001at 25° C., resuspending in water at 40° C. and final formulation ofmixed nanomicellar formulation encapsulating compound 1001 (HCO-60 wasmelted and compound 1001 was added to melt, then allowed to cool to roomtemperature and the physical appearance was noted) Final formula- tion(make up Physical appear- with 2X buffer HCO-60 1001 ance at room tem-Resuspend containing (wt %) (wt %) perature (25° C.) in water 0.01%Oc-40) 1.0 4 Pale yellow half Emulsion Emulsion solid and half viscousliquid 2.0 4 Pale yellow Forms pale Pale yellow viscous solid emulsionclear solution (with waxy and viscous liquid) 2.25 4 Pale yellow Formspale Pale yellow waxy solid emulsion clear solution 2.5 4 Pale yellowForms very Pale yellow waxy solid pale emulsion clear solution 2.75 4Pale yellow Forms very Clear solution waxy solid pale emulsion 3.0 4Pale yellow Clear solution Clear solution waxy solid 3.5 4 Pale yellowClear solution Clear solution waxy solid 4.0 4 Pale yellow Clearsolution Clear solution waxy solid

TABLE 2b Physical appearance for HCO-40 and compound 1001 melt mixtureat 25° C., resuspending in water and final formulation of mixednanomicellar formulation encapsulating compound 1001 (HCO-40 was meltedand compound 1001 was added to melt at 40° C. Then allowed to cool toroom temperature and the physical appearance was noted) Mixture physi-cal appearance HCO-40 1001 at room temper- Resuspend Final (wt %) (wt %)ature (25° C.) in water formulation 0.5 4 Viscous yel- Emulsion Emulsionlow liquid 0.75 4 Viscous yel- Emulsion Emulsion low liquid 1.0 4Viscous yel- Emulsion Emulsion low liquid 1.25 4 Viscous yel- EmulsionEmulsion low liquid 1.5 4 Viscous yel- Emulsion Emulsion low liquid 1.754 Viscous yel- Emulsion Emulsion low liquid 2.0 4 Viscous yel- EmulsionEmulsion low liquid 2.25 4 Viscous yel- Emulsion Emulsion low liquid 2.54 Viscous yel- Yellow Yellow color low liquid solution solution 2.75 4Viscous yel- Pale yellow Pale yellow low liquid solution color solution3.0 4 Viscous yel- Clear Clear low liquid solution solution 4.0 4Viscous yel- Clear Clear low liquid solution solution

TABLE 2c Physical appearance of HCO-40 and compound 1001 melt mixture at25° C. and 4° C., mixture resuspended in water at 40° C. and finalformulation. Mixture physical Mixture physical appearance at appearanceat Allow to reach room room room HCO-40 1001 temperature temperaturetemperature Resuspend Final (wt %) (wt %) (25° C.) (4° C.) (25° C.) inwater formulation 0.5 4 Viscous yellow Viscous liquid Viscous liquidEmulsion Emulsion liquid 0.75 4 Viscous yellow Viscous liquid Viscousliquid Emulsion Emulsion liquid 1.0 4 Viscous yellow Viscous liquidViscous liquid Emulsion Emulsion liquid 1.25 4 Viscous yellow Viscousliquid Viscous liquid Emulsion Emulsion liquid 1.5 4 Viscous yellowYellow waxy Viscous liquid Emulsion Emulsion liquid solid 1.75 4 Viscousyellow Yellow waxy Viscous liquid Emulsion Emulsion liquid solid 2.0 4Viscous yellow Yellow waxy Viscous liquid Emulsion Emulsion liquid solid2.25 4 Viscous yellow Yellow waxy Viscous liquid Emulsion Emulsionliquid solid 2.5 4 Viscous yellow Yellow waxy Viscous liquid YellowYellow color liquid solid solution solution 2.75 4 Viscous yellow Paleyellow waxy Viscous liquid Pale yellow Very pale yellow liquid solidsolution color solution 3.0 4 Viscous yellow Pale yellow solid Viscousliquid Clear Clear solution liquid (half solid half solution viscousliquid) 4.0 4 Viscous yellow Pale yellow waxy Pale yellow Clear Clearsolution liquid solid waxy solid solution (HCO-40 was melted andcompound 1001 was added to melt at 40° C. Then allowed to cool to roomtemperature, placed at 4° C. and brought back to room temperature.Physical appearance of mixture was noted at all temperatures)

Conclusions.

These studies show that the polymer HCO-60 can be used to entrapcompound 1001 with Hot Melt method. HCO-40 did not develop waxy solid athigher weight percent (3.0%) under the conditions of this study. On theotherhand, HCO-60 developed waxy solid at 2.0 wt %. This method hasunique advantages of being an easy and fast method that avoids the useof organic solvent in the preparation of MNF. Also, the method ofpreparation is easy and fast. The waxy solid developed in stage 1 may behelpful in preventing the drug degradation and help the drug to stay inwaxy solid state at room temperatures with a blanket of inert gas.Qualitative proton NMR studies show that drug is not freely availablewhen resuspended in aqueous solution. On the otherhand, when the sameformulation was resuspended in organic solvent, CDCl₃, drug peaks wereclearly evident indicating the presence of drug in the outer organicsolvent environment due to the formation.

Example 5 Preparation of Mixed Nanomicellar Cyclosporine Formulation

MNF formulation of cyclosporineA (Cys-A) was prepared by solventevaporation method in two steps: 1. Preparation of basic formulation and2. rehydration. In step one, cyclosporine, HCO-40 and octoxynol-40 weredissolved separately in 0.5 mL of ethanol aliquots. These threesolutions were mixed together in a round bottom flask. The resultantmixture was stirred to obtain a homogenous solution. Ethanol solvent wasremoved by high speed vacuum evaporation overnight to obtain a solidthin film. In step two, the resultant thin film was hydrated with 2.0 mLof double distilled deionized water and resuspended with stirringovernight. The rehydrated formulation was pH adjusted and volume wasmade up with 2× phosphate buffer solution, (pH 6.8). Further theformulation was filtered through 0.2 μm nylon filter membrane to removethe unentrapped drug aggregates and other foreign particulates.

Different polymer weight percent combination than were used for theabove resolvin examples were used to develop aqueous MNF entrapping 0.2wt % cyclosporine-A. Formulations were characterized for theirappearance, size and polydispersity indices. The formulations were foundto be clear and have very small size with narrow polydispersity index.The results are summarized in tables 3a and 3b.

TABLE 3a Cyclosporine mixed nanomicellar formulations at lower polymerconcentrations. HCO-40 Octoxynol-40 Visual Size Polydispersity wt % wt %appearance (nm) index 0.5 0.1 Emulsion N.D N.D 0.75 0.1 Emulsion N.D N.D1 0.1 Emulsion N.D N.D 1.25 0.1 Emulsion N.D N.D 1.5 0.1 Emulsion N.DN.D 1.75 0.1 Clear solution 14.86 0.062 2.00 0.1 Clear solution 36.140.884 0.5 0.5 Emulsion N.D N.D 0.75 0.5 Emulsion N.D N.D 1 0.5 EmulsionN.D N.D 1.25 0.5 Emulsion N.D N.D 1.5 0.5 Emulsion N.D N.D 1.75 0.5Clear solution 14.81 0.075 2.00 0.5 Clear solution 21.27 0.295 N.D—NotDetermined.

TABLE 3b Cyclosporine mixed nanomicellar formulations at higher polymerconcentrations. HCO-40 Octoxynol-40 Visual Size Polydispersity wt % wt %appearance (nm) index 0.5 1.0025 Clear solution 12.9 0.069 0.5 2 Clearsolution 18.1 0.069 2.5 0.005 Clear solution 15.65 0.064 2.5 1.0025Clear solution 14.56 0.096 2.5 1.0025 Clear solution 14.81 0.078 2.51.0025 Clear solution 14.80 0.098 2.5 1.0025 Clear solution 14.45 0.1022.5 2 Clear solution 13.92 0.108 4.5 0.005 Clear solution 20.59 0.2714.5 1.0025 Clear solution 15.08 0.087 4.5 2 Clear solution 15.37 0.079

Water Method.

MNF formulation of cyclosporinA (CsA) was prepared by the water method.One mL of double distilled deionized water was heated to 60° C. in around bottom flask. This heated water was kept under stirring. HCO-40was added to the heated water and allowed to dissolve under constantstirring. Octoxynol-40 was then added to this mixture and allowed todissolve. In a separate container, phosphates, sodium chloride and CsAwere blended by hand shaking for a few minutes. Under stirringconditions, the phosphates/CsA/sodium chloride blend was added to thesolution of HCO-40 and octoxynol-40 to disperse the drug. This mixturewas allowed to cool to room temperature while stirring and check forcomplete dissolution of drug. PVP K 90 solution was separately preparedusing the remaining 1 mL double distilled deionized water. This PVP K 90solution was added to the solution ofpolymer/surfactant/drug/phosphate/sodium chloride. Water was added tomake up the final volume. Then the formulation was filtered through 0.2μm nylon membrane to remove the drug aggregates and other foreignparticulates.

Example 6 Local Tolerability in Rabbits of Formulations

Healthy young adult New Zealand albino rabbits (3-4 Kg) used for thestudy the local tolerability of the instant formulations, for example aformulation of Examples 1-5. One drop (approximately 30. mu.L) of salineis placed in one eye and a drop of formulation is placed in the othereye of the rabbit. Both eyes of each animal are examined by a veterinaryophthalmologist using a hand-held slit lamp and indirect ophthalmoscope.Both control and test eyes are graded according to conjunctivalcongestion, swelling, and discharge, aqueous flare, iris light reflexand involvement, corneal cloudiness severity and area, pannus,fluorescein examination and lens opacity using the Hackett/McDonaldscoring system (see, for example, Hackett, R. B. and McDonald, T. O.Ophthalmic Toxicology and Assessing Ocular Irritation. Dermatoxicology,5.sup.th Edition. Ed. F. N. Marzulli and H. I. Maibach. Washington,D.C.: Hemisphere Publishing Corporation. 1996; 299-305 and 557-566.). Inthe fluorescein examination, approximately one drop of 0.9% sodiumchloride, USP, is applied to the end of a fluorescein impregnated stripand then applied to the superior sclera of the left and right eyes (onefluorescein impregnated strip is used for each animal). After anapproximate 15 second exposure, the fluorescein dye is gently rinsedfrom each eye with 0.9% sodium chloride, USP. The eyes are then examinedusing a slit lamp with a cobalt blue filtered light source. For thelenticular examination approximately one drop of a short-actingmydriatic solution is instilled onto each eye in order to dilate thepupil. After acceptable dilation has occurred, the lens of each eye isexamined using a slit-lamp biomicroscope.

The crystalline lens is observed with the aid of the slit-lampbiomicroscope, and the location of lenticular opacity is discerned bydirect and retro illumination. The location of lenticular opacities arearbitrarily divided into the following lenticular regions beginning withthe anterior capsule: Anterior subcapsular, Anterior cortical NuclearPosterior cortical, Posterior subcapsular, Posterior capsular. The lensis evaluated routinely during ocular evaluations and graded as either 0(normal) or 1 (abnormal). The presence of lenticular opacities aredescribed and the location noted.

Example 7 Ocular Tissue Distribution of Formulations of 0.05 wt %, 0.2wt % and 0.5 wt % in Mixed Micellar Formulations of the PresentDisclosure

The temporal distribution and potential accumulation with repeat dosing,gender difference, and potential melanin binding of (ophthalmicsolution) of the present disclosure (for example the formulations ofExamples 1-5) after ocular application is assessed by determiningconcentration of active ingredients in ocular tissues, tears, and bloodin New Zealand White (NZW) and Dutch Belted (DB) rabbits.

NZW rabbits are used in a single dose (SD) and 7-day repeat dose (RD)studies. DB rabbits will be used in a single dose study). Animals areeither untreated (controls) or given a single or a daily topical oculardose for 7 days (0.05 wt %, 0.2 wt % or 0.5 wt % in a mixed micellarformulation to one or both eyes). Blood and ocular tissue concentrationsare assessed.

The concentration of drug is in tissues in the front of the eye (cornea,conjunctiva, sclera) and at the back of the eye (retina, optic nerve)but minimal in the middle of the eye (aqueous and vitreous humor),suggesting transport of the drug by a mechanism other than passivetransport through the eye. The high drug levels achieved at the back ofthe eye make topical administration of the compositions of the presentdisclosure feasible for the treatment of diseases of the back-of-the-eye(e.g., retinal, diseases involving optic nerve such as glaucoma). Veryhigh levels, especially in target tissues such as lachrymal gland, willbe shown with the compositions of the present disclosure.

Example 8 Use of Resolvin Mixed Nanomicellar Formulations for TreatingDry Eye

Mixed nanomicellar formulations according to Examples 1-5 areadministered to an patient having dry eye at a concentration of between0.05% and 0.2% b.i.d. over a period of 1 month to 1 year or more.

Example 9 Use of Resolvin Mixed Nanomicellar Formulations for TreatingDiabetic Retinopathy

Mixed nanomicellar formulations according to Examples 1-5 areadministered to an patient having proliferative diabetic retinopathy ata concentration of between 0.2 wt % to 0.5 wt % b.i.d. over a period of1 month to 1 year or more.

Example 10 Tollerance and Ocular Tissue Distribution of CyclosporineMixed Nanomicellar Formulations

A study was conducted in rabbits to test the tolerance and ocular tissuedistribution of a nanomicellar formulation of cyclosporine against itsplacebo and balanced saline solution (BSS). Healthy New Zealand femalewhite rabbits (2-3 kg) were used for this study. Cyclosporine study drugwas prepared having 0.1% cyclosporine essentially as described in theexamples herein. The below table shows the formulation composition ofthe CsA formulation and the Placebo.

TABLE 4 Formulation Composition: Components CsA 0.1% formulation PlaceboCyclosporine 0.1% 0 Hydrogenated castor oil-40 1.0% 1.0% Octoxynol-400.05% 0.05% Sodium chloride 0.10% 0.10% PVP-K90 0.60% 0.60% DisodiumEDTA 0.05% 0.05% Benzalkonium chloride 0.003% 0.003% Sodium Phosphatebuffer ~0.4% ~0.4% pH 7 7

One drop (approximately 35 μL) of study drug was applied o.d. 4×/day attwo hour intervals for 5 days. One drop of BSS was applied to thecontralateral eye.

The tolerance parameters evaluated were: physical examination(acclimation study release); viability (daily); clinical observations(daily); Hackett-McDonald Ocular Irritation scores (pre-dose baselinedata for each rabbit and then a pre-dose [prior to first daily dose]each day and then 30 min after last dose daily, intraocular pressure(IOP) pre-dose baseline data for each rabbit and then 30 minutes afterthe evening examinations each day, electroretinography (ERG) pre-dose-(pre-study) baseline data for each rabbit and then one hour after thelast treatment, and ocular histopathology at euthanasia.

Mean cumulative Hackett-McDonald ocular irritation scores demonstratedvery minimal scores for both BSS-treated left eyes and cyclosporinetreated right eyes throughout the study, both for pre-treatment andpost-treatment examination times. Mean cumulative inflammatory scores ofless than 2 were observed in eyes treated with the TA, placebo, and BSS.These clinical scores represented mild conjunctival hyperemia (redness)and swelling. However, there were no significant differences in meancumulative Hackett-McDonald ocular irritation scores between the groups,suggesting no difference in irritation from topical application of 0.1%CsA in HCO-40, the HCO-40 placebo, and BSS.

No changes in IOP were noted in eyes treated with BSS, HCO-40, or CsA.No toxicologic changes in retinal function were noted on ERG after 5days of treatment with the test articles. No toxicologic or inflammatorychanges were observed histologically in the anterior(conjunctiva/cornea/iris) or posterior segments (vitreous/retina) of theeye of any groups.

Samples of selected ocular tissues (aqueous humor, vitreous humor,conjunctiva, cornea, iris-ciliary body, lens, retina/choroid, andsclera) were collected 1 hour following the last dose on Day 5 from alltwo rabbits that received 0.1% CsA with HCO-40 (OD), and BSS (OS), andfrom one rabbit (No. 21) that received placebo HCO-40 formulation (OD)and BSS (OS). The samples were assayed for cyclosporine (CsA) by liquidchromatography-tandem mass spectrometry (LC-MS/MS). The internalstandard was d₄-cyclosporine. The established analytical ranges for CsAwere 0.100-100 ng/mL for whole blood, and 2.00-2000 ng/mL for aqueoushumor and vitreous humor. The analytical ranges for the solid tissueswere 0.125-30 ng (low range) and 1.00-2500 ng (high range). The resultsof the solid tissue analyses were converted to ng/g by correcting forthe amount of tissue analyzed.

Concentrations of CsA in ocular tissues collected 1 hour following thelast dose on Day-5 are summarized in Table 5. Following repeatedadministration of the 0.1% CsA HCO-40 formulation, the highest averageCsA concentrations in the treated eye were observed in cornea (7805ng/g), followed by conjunctiva (2125 ng/g), sclera (720 ng/g),iris-ciliary body (204 ng/g), and aqueous humor (134 ng/mL). The lowestCsA concentrations were observed in the lens (68.6 ng/g), retina/choroid(54 ng/g), and vitreous humor (˜8 ng/mL). CsA concentrations in thecollateral eye treated with BSS were quite low suggesting minimalsystemic transfer of drug.

The ocular tissue concentrations for the 0.1% CsA formulation observedin this study were generally higher than the C_(max) values followingrepeat dose administration (bid for 7 days) of an Allergan 0.2% 3Hcyclosporine A formulation to rabbits (see Acheampong A A, Shackleton M,Tang-Liu D, Ding S, Stern M E, Decker R Distribution of cyclosporin A inocular tissues after topical administration to albino rabbits and beagledogs; Current Eye Research 18(2); 1999; pp91-103).

TABLE 5 Nanomicellar Allergan Matrix 0.1% CsA 0.2% CsA Aqueous Humor 134.5 ng/mL   19.3 ng-eq/mL Vitreous Humor   8.37 ng/mL  0.810 ng-eq/mLSclera 720.5 ng/g  35.2 ng-eq/g Conjunctiva 2125 ng/g   ND ng-eq/gCornea 7805 ng/g  6011 ng-eq/g  Iris-Ciliary Body  204 ng/g  109 ng-eq/gLens 68.6 ng/g 39.6 ng-eq/g Retina/Choroid 53.7 ng/g 4.62 ng-eq/g

Example 11 Tollerance and Ocular Tissue Distribution of Compound 1001Mixed Nanomicellar Formulations

A study was conducted in rabbits to test the tolerance and ocular tissuedistribution of two nanomicellar formulations of compound 1001 (RX10045)against matching placebos (Table 6a and 6b) and balanced saline solution(BSS). Healthy New Zealand female white rabbits (2-3 kg) were used forthis study. One drop (approximately 35 μL) of study drug was appliedo.d. 4×/day at two hour intervals for 5 days. One drop of BSS wasapplied to the contralateral eye.

The tolerance parameters evaluated were: physical examination(acclimation study release); viability (daily); clinical observations(daily); Hackett-McDonald Ocular Irritation scores (pre-dose baselinedata for each rabbit and then a pre-dose [prior to first daily dose]each day and then 30 min after last dose daily, intraocular pressure(IOP) pre-dose baseline data for each rabbit and then 30 minutes afterthe evening examinations each day, electroretinography (ERG) pre-dose-(pre-study) baseline data for each rabbit and then one hour after thelast treatment, and ocular histopathology at euthanasia.

TABLE 6a Formulation Composition: RX-10045 0.15% RX-10045 (0.1%) inHCO-40 Placebo Components percentage percentage RX-10045 0.1% 0Hydrogenated Castor Oil-40 1.0% 1.0% Octoxynol-40 0.05% 0.05% Sodiumchloride 0.10% 0.10% PVP-K90 0.60% 0.60% Disodium EDTA 0.05% 0.05%Benzalkonium chloride 0.003% 0.003% Sodium Phosphate buffer ~0.4% ~0.4%pH 5.5 5.5

TABLE 6b Formulation Composition: RX-10045 0.1% RX-10045 (0.15%) inHCO-60 Placebo Components percentage Percentage RX-10045 0.15% 0Hydrogenated Castor Oil-60 1.0% 1.0% Octoxynol-40 0.05% 0.05% Sodiumchloride 0.10% 0.10% PVP-K90 0.60% 0.60% Disodium EDTA 0.05% 0.05%Benzalkonium chloride 0.003% 0.003% Sodium Phosphate buffer ~0.4% ~0.4%pH 5.5 5.5

Cumulative Hackett-McDonald ocular irritation scores demonstrated veryminimal mean values for both BSS-treated left eyes and test-articletreated right eyes throughout the study, both for pre-treatment andpost-treatment examination times. There were no significant differencesin mean cumulative Hackett-McDonald ocular irritation scores between thegroups (Table 7). The observed ocular irritation was interpreted asminimal and transient in all groups.

TABLE 7 Hackett-McDonald Composite Scores (mean ± s.d.) JICO-40 RX-10045JICO-60 RX-10045 Placebo^(a) 0.1%^(b) Placebo^(a) 0.15%^(b) Day 1Predose 0.0-0.0 0.0-0.0 0.0-0.0 0.0-0.0 Day 1 Postdose 1.7-1.5 0.5-0.10.0-0.0 0.5-0.1 Day 2 Predose 0.0-0.0 0.0-0.0 0.0-0.0 1.0-1.2 Day 2Postdose 2.0-0.0 0.0-0.0 07.-1.1 0.5-1.0 Day 3 Predose 0.0-0.0 0.0-0.00.0-0.0 0.5-1.0 Day 3 Postdose 1.3-1.2 0.0-0.0 0.0-0.0 1.0-1.2 Day 4Predose 1.3-1.2 0.0-0.0 0.3-0.6 0.5-1.0 Day 4 Postdose 1.3-1.2 0.0-0.00.7-1.2 0.8-1.0 Day 5 Predose 0.0-0.0 0.5-1.0 1.0-1.0 0.0-0.0 Day 5Postdose 1.3-2.3 0.0-0.0 0.3-0.6 0.8-1.1

No changes in IOP were noted in eyes treated with BSS or test articles.No toxicologic changes in retinal function were noted on ERG after 5days of treatment with the test articles. No toxicologic or inflammatorychanges were observed histologically in the anterior(conjunctiva/cornea/iris) or posterior segments (vitreous/retina) of theeye of any groups.

Selected ocular fluids/tissues (aqueous humor, vitreous humor,conjunctiva, cornea, iris-ciliary body, lens, retina/choroid, andsclera) collected from two rabbits each in the RX-10045 (0.15% inHCO-60, 0.1% in HCO-40) treatment groups, and from one rabbit in each ofthe matching placebo groups, were assayed for compound 1001 and anotherresolvin by liquid chromatography-tandem mass spectrometry (LC-MS/MS).Warfarin-d₅ and 5-HDA were used as internal standards for the analysisof RX-10045 and its active metabolite, RX-10008, respectively, inaqueous humor and vitreous humor. For the other ocular tissues (solidtissues), warfarin-d5 and phenyl acetic acid-d5 (PAA-d₅) were used asthe internal standards for compound 1001 and RX-10008, respectively. Theanalytical range for the solid tissues were 0.125-100 ng. The results ofthe solid tissue analyses were converted to ng/g by correcting for theamount of tissue analyzed.

Only sporadic, relatively low, concentrations of the compound 1001 esterprodrug were observed in the sclera and conjunctiva. Compound 1001 waseither not detected or was below the quantitation limit of the assay inthe majority of ocular tissues. These data suggest that RX-10045 wasrapidly hydrolyzed to its active metabolite, RX-10008.

A summary of the parent compound (RX-10008) tissue concentrations arepresented in Table 8. The highest concentrations of RX-10008 were foundin the cornea, followed by the iris-ciliary body, conjunctiva, andsclera. There were also relatively high concentrations of RX-10008 inthe aqueous humor. Lower amounts were found in the retina/choroid andlens. The lowest levels of RX-10008 were found in the vitreous humor.

TABLE 8 Comparison of mean (n = 2) RX-10008 ocular tissue concentrationsfollowing topical ocular administration of RX-10045 (0.15% in HCO- 60,0.1% in HCO-40) formulations to the eye four times a day at 2 hourintervals for five days to New Zealand White Rabbits Treatment Group 4Treatment Group 5 0.15% RX-10045 0.1% RX-10045 in HCO-60 in HCO-40RX-1008 (ng/g or ng/mL) Sclera  990^(a) 701 Cornea 15700^(a)  9650^(a)  Conjunctiva 1132  879 Lens 136 164 Iris-Ciliary Body 2725  2655 Retina/Choroid 410 323 Vitreous Humor  18   15.7 AqueousHumor >2000  >2000  ^(a)n = 1

The invention illustratively described herein may be practiced in theabsence of any element or elements, limitation or limitations which isnot specifically disclosed herein. The terms and expressions which havebeen employed are used as terms of description and not of limitation,and there is no intention that in the use of such terms and expressionsof excluding any equivalents of the features shown and described orportions thereof, but it is recognized that various modifications arepossible within the scope of the invention claimed. Thus, it should beunderstood that although the present invention has been specificallydisclosed by preferred embodiments and optional features, modificationand variation of the concepts herein disclosed may be resorted to bythose skilled in the art, and that such modifications and variations areconsidered to be within the scope of this invention as defined by theappended claims.

The contents of the articles, patents, and patent applications, and allother documents and electronically available information mentioned orcited herein, are hereby incorporated by reference in their entirety tothe same extent as if each individual publication was specifically andindividually indicated to be incorporated by reference. Applicantsreserve the right to physically incorporate into this application anyand all materials and information from any such articles, patents,patent applications, or other documents.

The inventions illustratively described herein may suitably be practicedin the absence of any element or elements, limitation or limitations,not specifically disclosed herein. Thus, for example, the terms“comprising”, “including,” containing”, etc. shall be read expansivelyand without limitation. Additionally, the terms and expressions employedherein have been used as terms of description and not of limitation, andthere is no intention in the use of such terms and expressions ofexcluding any equivalents of the features shown and described orportions thereof, but it is recognized that various modifications arepossible within the scope of the invention claimed. Thus, it should beunderstood that although the present invention has been specificallydisclosed by preferred embodiments and optional features, modificationand variation of the inventions embodied therein herein disclosed may beresorted to by those skilled in the art, and that such modifications andvariations are considered to be within the scope of this invention.

The invention has been described broadly and generically herein. Each ofthe narrower species and subgeneric groupings falling within the genericdisclosure also form part of the invention. This includes the genericdescription of the invention with a proviso or negative limitationremoving any subject matter from the genus, regardless of whether or notthe excised material is specifically recited herein.

In addition, where features or aspects of the invention are described interms of Markush groups, those skilled in the art will recognize thatthe invention is also thereby described in terms of any individualmember or subgroup of members of the Markush group.

Other embodiments are set forth within the following claims.

What is claimed is:
 1. An ophthalmic formulation, comprisingcyclosporine, a polyoxyl lipid or fatty acid and a polyalkoxylatedalcohol.
 2. The ophthalmic formulation of claim 1, wherein said polyoxlylipid comprises one or more selected from the group consisting ofHCO-40, HCO-60, HCO-80, HCO-100, polyoxyl 40 stearate and polyoxyl 35castor oil.
 3. The ophthalmic formulation of claim 1, wherein saidpolyoxly lipid comprises one or more selected from the group consistingof HCO-40, HCO-60 and HCO-80.
 4. The ophthalmic formulation of claim 1,wherein said polyoxly lipid comprises HCO-40.
 5. The ophthalmicformulation of claim 1, wherein said polyoxly lipid comprises one ormore selected from the group consisting of HCO-60, HCO-80, HCO-100,polyoxyl 40 stearate and polyoxyl 35 castor oil and is present in anamount between 0.05-5% of the formulation.
 6. The ophthalmic formulationof claim 1, wherein said polyoxly lipid comprises one or more selectedfrom the group consisting of HCO-40, HCO-60, HCO-80, HCO-100, polyoxyl40 stearate and polyoxyl 35 castor oil and is present in an amountbetween 0.5-1.5% of the formulation.
 7. The ophthalmic formulation ofclaim 1, wherein said polyoxly lipid comprises one or more selected fromthe group consisting of HCO-40 HCO-60, and HCO-80, and is present in anamount between 0.5-1.5% of the formulation.
 8. The ophthalmicformulation of claim 1, wherein said polyalkoxylated alcohol isOctoxynol-40.
 9. The ophthalmic formulation of claim 1, wherein thepolyalkoxylated alcohol is Octoxynol-40 and is present in an amountbetween 0.02 and 4% of the formulation.
 10. The ophthalmic formulationof claim 1, wherein the polyalkoxylated alcohol is Octoxynol-40 and ispresent in an amount between 0.02 and 0.1% of the formulation.
 11. Theophthalmic formulation of claim 1, wherein the cyclosporine is presentin an amount between 0.05 and 5% of the formulation.
 12. The ophthalmicformulation of claim 1, wherein the cyclosporine is present in an amountbetween 0.05 and 0.2% of the formulation.
 13. The ophthalmic formulationof claim 1, wherein said polyoxly lipid comprises one or more selectedfrom the group consisting of HCO-40, HCO-60, HCO-80, HCO-100, polyoxyl40 stearate and polyoxyl 35 castor oil; and wherein said polyalkoxylatedalcohol is Octoxynol-40.
 14. The ophthalmic formulation of claim 1,wherein said polyoxly lipid comprises one or more selected from thegroup consisting of HCO-40, HCO-60, HCO-80, HCO-100, polyoxyl 40stearate and polyoxyl 35 castor oil and is present in an amount between0.5-5% of the formulation; and said polyalkoxylated alcohol isOctoxynol-40 and is present in an amount between 0.02 and 4% of theformulation.
 15. The ophthalmic formulation of claim 1, wherein saidpolyoxly lipid comprises one or more selected from the group consistingof HCO-40, HCO-60, HCO-80, HCO-100, polyoxyl 40 stearate and polyoxyl 35castor oil and is present in an amount between 0.5-1.5% of theformulation; and said polyalkoxylated alcohol is Octoxynol-40 and ispresent in an amount between 0.02 and 0.1% of the formulation.
 16. Theophthalmic formulation of claim 1, wherein said polyoxly lipid comprisesone or more selected from the group consisting of HCO-40, HCO-60,HCO-80, HCO-100, polyoxyl 40 stearate and polyoxyl 35 castor oil and ispresent in an amount between 0.5-5% of the formulation; saidpolyalkoxylated alcohol is Octoxynol-40 and is present in an amountbetween 0.02 and 4% of the formulation; and the cyclosporine is presentin an amount between 0.05 and 5% of the formulation.
 17. The ophthalmicformulation of claim 1, wherein said polyoxly lipid comprises one ormore selected from the group consisting of HCO-40, HCO-60, HCO-80,HCO-100, polyoxyl 40 stearate and polyoxyl 35 castor oil and is presentin an amount between 0.5-1.5% of the formulation; and saidpolyalkoxylated alcohol is Octoxynol-40 and is present in an amountbetween 0.02 and 0.1% of the formulation; and the cyclosporine ispresent in an amount between 0.05 and 0.2% of the formulation.
 18. Theophthalmic formulation of claim 1, wherein said formulation comprisesnanomicelles.
 19. A method of treating or preventing an ocular diseaseor condition, said method comprising topically administering aformulation of claim
 1. 20. A method of treating or preventing an oculardisease or condition, said method comprising topically administering aformulation of claim 17.